Evidence map›Paper›PMID 38752923›Full record

Trial reportDiabetes care2024

Medical Assistant Health Coaching for Type 2 Diabetes in Primary Care: Results From a Pragmatic Cluster Randomized Controlled Trial.

Addie L Fortmann, Emily C Soriano, Linda C Gallo, Taylor L Clark, Samantha R Spierling Bagsic, Haley Sandoval, Jennifer A Jones, Scott Roesch, Todd Gilmer, James Schultz and 2 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in Diabetes care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Addie L FortmannScripps Whittier Diabetes Institute, San Diego, CA.ORCID 0000-0002-0350-5288
Emily C SorianoScripps Whittier Diabetes Institute, San Diego, CA.ORCID 0000-0002-1069-9324
Linda C GalloDepartment of Psychology, San Diego State University, San Diego, CA.
Taylor L ClarkSan Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA.
Samantha R Spierling BagsicScripps Whittier Diabetes Institute, San Diego, CA.
Haley SandovalScripps Whittier Diabetes Institute, San Diego, CA.
Jennifer A JonesScripps Whittier Diabetes Institute, San Diego, CA.
Scott RoeschDepartment of Psychology, San Diego State University, San Diego, CA.
Todd GilmerHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA.
James SchultzNeighborhood Healthcare, Escondido, CA.
Thomas BodenheimerDepartment of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, CA.
Athena Philis-TsimikasScripps Whittier Diabetes Institute, San Diego, CA.

Funding

New York Regional Center for Diabetes Translation Research - Translational Intervention Methodology CoreP30DK111022 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI JEFFREY GONZALEZ · 2016 to 2026
$7.8M
CTSA K12 Program at The Scripps Research InstituteK12TR004410 · NCATS · SCRIPPS RESEARCH INSTITUTE, THE · PI Laura Nicholson, Athena Philis-Tsimikas · 2023 to 2026
$3.9M
Medical Assistant Health Coaching for Diabetes in Diverse Primary Care SettingsR18DK104250 · NIDDK · SCRIPPS HEALTH · PI GALLO, LINDA C, PHILIS-TSIMIKAS, ATHENA · 2015 to 2019
$2.3M
NCATS NIH HHS K12 TR004410NIDDK NIH HHS P30 DK111022NIDDK NIH HHS R18 DK104250NIDDK NIH HHS R18DK104250
6 · The paper itself

Abstract

objectiveThis cluster (clinic-level) randomized controlled trial (RCT) compared medical assistant (MA) health coaching (MAC) with usual care (UC) among at-risk adults with type 2 diabetes in two diverse real-world primary care environments: a federally qualified health center (FQHC; Neighborhood Healthcare) and a large nonprofit private insurance-based health system (Scripps Health). RESEARCH DESIGN AND

methodsA total of 600 adults with type 2 diabetes who met one or more of the following criteria in the last 90 days were enrolled: HbA1c ≥8% and/or LDL cholesterol ≥100 mg/dL and/or systolic blood pressure (SBP) ≥140 mmHg. Participants at MAC clinics received in-person and telephone self-management support from a specially trained MA health coach for 12 months. Electronic medical records were used to examine clinical outcomes in the overall sample. Behavioral and psychosocial outcomes were evaluated in a subsample (n = 300).

resultsAll clinical outcomes improved significantly over 1 year in the overall sample (P < 0.001). The reduction in HbA1c was significantly greater in the MAC versus UC group (unstandardized Binteraction = -0.06; P = 0.002). A significant time by group by site interaction also showed that MAC resulted in greater improvements in LDL cholesterol than UC at Neighborhood Healthcare relative to Scripps Health (Binteraction = -1.78 vs. 1.49; P < 0.05). No other statistically significant effects were observed.

conclusionsThis was the first large-scale pragmatic RCT supporting the real-world effectiveness of MAC for type 2 diabetes in U.S. primary care settings. Findings suggest that this team-based approach may be particularly effective in improving diabetes outcomes in FQHC settings.

Indexed as

Diabetes Mellitus, Type 2MentoringPrimary Health CareAdultAgedAllied Health PersonnelFemaleGlycated HemoglobinHumansMaleMiddle AgedGlycated Hemoglobin

Identifiers

PMID38752923
PMCPMC11208755

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.